Materials And Methods: The present study was conducted in a tertiary reference center in Turkey for six years period. The accurate diagnosis of six NKH patients was based on clinical history of the patients, neurological examinations, seizure semiology, serial electroencephalography (EEG) recordings, neuroimaging findings, metabolic tests and genetic analysis. Read More

Purpose: To assess whether hippocampal atrophy develops in conjunction with clinical or subclinical epileptiform or encephalopathic activity in subjects with neurocysticercosis (NCC).

Methods: Using a population-based and nested case-control study design, scalp EEGs and brain MRIs were performed in Atahualpa residents aged ≥40 years, who have imaging-confirmed NCC (case patients), as well as in age- and sex-matched NCC-free control subjects.

Results: Sixty-two case patients and 62 control subjects were included. Read More

Introduction: Nonconvulsive seizures (NCS) are frequent in hospitalized patients and may further aggravate injury in the already damaged brain, potentially worsening outcomes in encephalopathic patients. Therefore, both early seizure recognition and treatment have been advocated to prevent further neurological damage.

Objective: Evaluate the main EEG patterns seen in patients with impaired consciousness and address the effect of treatment with antiepileptic drugs (AEDs), continuous intravenous anesthetic drugs (IVADs), or the combination of both, on outcomes. Read More

Introduction: Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic encephalopathic state associated with reversible cerebral vasogenic edema. Seizures are a common clinical presentation in PRES, however its electroencephalographic and radiologic pattern correlation is limited in this subset of patients. The aim of this study is to analyze the origin of electrographic dysfunction according to the radiologic pattern in patients with PRES and seizures. Read More

Authors:

Department of Critical Care, Neuroscience and Mental Health Program, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Canada.

Acute brain injury is a common cause of death and critical illness in children and young adults. Fundamental management focuses on early characterization of the extent of injury and optimizing recovery by preventing secondary damage during the days following the primary injury. Currently, bedside technology for measuring neurological function is mainly limited to using electroencephalography (EEG) for detection of seizures and encephalopathic features, and evoked potentials. Read More

Background: Autoimmune encephalitis is currently a clinical diagnosis without widely accepted diagnostic criteria, often leading to a delay in diagnosis. The utility of magnetic resonance imaging (MRI) and electroencephalography (EEG) in this disease is unknown. The objective of this study was to identify disease-specific patterns of neurodiagnostic studies (MRI and EEG) for autoimmune encephalitis in children. Read More

Background And Purpose: Acute encephalopathy in hospitalized patients is common and associated with high mortality. Preservation of physiological sleep has been associated with favorable outcomes in acute brain injury. It is hypothesized that electroencephalographic presence of sleep elements is associated with good outcome in encephalopathic adults. Read More

Authors:

The International League Against Epilepsy (ILAE) Commission report on classification and terminology indicates that "diagnosing an individual as having an encephalopathic course requires demonstration of a failure to develop as expected relative to the same-aged peers or to regress in abilities." In this chapter, basing our discussion on the theoretical framework of neuroconstructivism, on the latest results deriving from functional neuroimaging and on the concept of system epilepsy, we use continuous spike-waves during slow-wave sleep (CSWS) as an example of how non-rapid eye movement (NREM) sleep spikes interfere with the organization and consolidation of neuropsychological networks in the sensitive phase of development, affecting also interconnected systems. Indeed, recent discoveries show that the normal overnight downscaling of slow wave activity (SWA) from the first to the last hours of sleep is absent in electrical status epilepticus during sleep (ESES) patients, thus impairing the neural process and possibly the local plastic changes associated with learning and other cognitive functions. Read More

Background: The expertise required for proper electroencephalography (EEG) setup can make the 10-20 array unwieldy in the hospital setting. There may be a role for an EEG array with reduced leads to improve the efficiency of inpatient practice.

Methods: Clips from 100 EEG records, 50 ictal and 50 non-ictal, in adult inpatients from January 1, 2007, to January 1, 2012, were retrospectively reviewed and selected for digital lead reduction and blind review. Read More

Authors:

Divisions of *Critical Care and †Neurology, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.

EEG patterns in pediatric encephalopathy are largely nonspecific and may be seen in a wide variety of pathologies. However, EEG can play a valuable role in helping to assess the severity and ultimate prognosis in pediatric encephalopathies. This review article considers three of the most common forms of pediatric encephalopathy encountered in pediatric critically care units, including hypoxic ischemic encephalopathy, central nervous system infections, and metabolic encephalopathies. Read More

Objective: Triphasic waves (TWs) are a frequent electroencephalography (EEG) finding in encephalopathy, yet their origin and prognostic significance are not well understood. The aim of this study was to determine the clinical and EEG characteristics in encephalopathic patients with TWs. We hypothesized that specific EEG characteristics are predictive of outcome. Read More

Authors:

Division of Neurology, The Perelman School of Medicine at the University of Pennsylvania, USA.

Purpose: Electrographic seizures (ES) and electrographic status epilepticus (ESE) are common in encephalopathic children in the pediatric intensive care unit (PICU) and associated with worse short-term outcome. Survey data indicate most physicians treat ES and ESE with antiepileptic drugs (AEDs), but few data are available regarding AED usage patterns. We aimed to describe AED usage for ES and ESE in critically ill children. Read More

To identify the relationship between pathologic electroencephalographic (EEG) patterns, clinical and neuroradiological abnormalities, and outcome in hospitalized patients with acute encephalopathy. This 5-year cohort study was performed at an academic tertiary care center. EEGs in 154 patients with altered mental status were classified according to five predefined patterns: Isolated continuous slowing of background activity (theta, theta/delta, and delta activity) and patterns with slowing background activity with episodic transients [i. Read More

Object: Traumatic brain injury (TBI) often causes an encephalopathic state, corresponding amplitude suppression, and disorganization of electroencephalographic activity. Clinical recovery in patients who have suffered TBI varies, and identification of patients with a poor likelihood of functional recovery is not always straightforward. The authors sought to investigate temporal patterns of electrophysiological recovery of neuronal networks in an animal model of TBI. Read More

Authors:

There is significant variability and controversy regarding the interpretation, nomenclature, and clinical implications of many EEG patterns seen in encephalopathic patients. The American Clinical Neurophysiology Society has attempted to create well-defined, objective rules for naming these patterns in order to allow scientific investigation into their significance. After many revisions, clarifications in definitions, and Web-based training modules, interrater reliability has improved. Read More

Authors:

Patients with metabolic disorders often, especially as newborns, present with encephalopathy and seizures, frequently requiring intensive care during metabolic crises. Cerebral function monitoring using amplitude integrated electroencephalography (aEEG) can be utilized to supplement clinical assessment and other monitoring already in use in the intensive care setting. In this technique, a one or two-channel EEG tracing is obtained, processed, compressed and displayed. Read More

Neonatal electroencephalogram (EEG), though often perceived as being difficult to record and interpret, is relatively easy to study due to the immature nature of the brain, which expresses only a few well-defined set of patterns. The EEG interpreter needs to be aware of the maturational changes as well as the effect of pathological processes and medication on brain activity. It gives valuable information for the treatment and prognostication in encephalopathic neonates. Read More

Background: The neuropathology of hypoglycemia and its mechanisms have been well studied. However, the physiopathogenesis of hypoglycemia-related seizures has escaped elucidation. Various animal models reportedly show "seizures" when rendered hypoglycemic, however, correlation with the electroencephalogram (EEG) is inconsistent. Read More

Authors:

The purpose of this study was to investigate the frequency and clinical outcome of patients with encephalopathic electroencephalograms (EEGs) in a neurophysiology department based in a general hospital. We performed a retrospective review of all EEGs obtained during an 18-month period in a large tertiary referral hospital. The referral reasons for EEG, the diagnoses reached, and patient outcomes were reviewed according to EEG severity. Read More

Authors:

Department of Neurology, Comprehensive Epilepsy Center, Neurological Institute, Columbia University, College of Physicians and Surgeons, New York, New York 10032, USA.

Purpose: We have previously demonstrated that it is common for alerting stimuli to induce electrographic seizures and other periodic or rhythmic patterns in the critically ill; however, only 1 of the first 33 patients we reported with this phenomenon had a detectable clinical correlate.

Methods: Review of charts and video EEG findings in critically ill patients in a neurological ICU at a tertiary care medical center in Manhattan.

Aims: There is considerable variation in the use of brain imaging and electrophysiological monitoring of encephalopathic term infants. The aims of this study were (i) to document the current practice among Australian and New Zealand neonatologists; and (ii) to identify the factors that influence local practice.

Methods: A postal questionnaire was sent to all 152 neonatologists in Australia and New Zealand. Read More

Authors:

Originally described in patients with chronic epilepsy, nonconvulsive seizures (NCSs) are being recognized with increasing frequency, both in ambulatory patients with cognitive change, and even more so in the critically ill. In fact, the majority of seizures that occur in the critically ill are nonconvulsive and can only be diagnosed with EEG monitoring. The semiology of NCSs and the associated EEG findings are quite variable. Read More

Authors:

Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London WC1N 3BG, UK.

Nonconvulsive status epilepticus (NCSE) is relatively common; it comprises at least one third of all cases of status epilepticus. NCSE may be an even more common, yet more elusive, condition in the elderly population. NCSE can be divided into complex partial status epilepticus (CPSE), NCSE in coma, and typical absence status epilepticus (TAS). Read More

Authors:

The diagnosis of idiopathic generalized epilepsies (IGEs) is not generally difficult if one follows the clinical and electroencephalogram (EEG) definitions of each subsyndrome that constitutes IGEs. In contrast, symptomatic epilepsies develop based on organic brain lesions and are easily diagnosed by the presence of developmental delay, neurologic abnormalities, and a characteristic seizure and EEG pattern. However, in clinical practice, it is sometimes difficult to differentiate IGEs from symptomatic epilepsies, especially when the clinical course from the onset of epilepsy is too short to exhibit typical clinical and EEG findings of either epilepsy type, or when patients with symptomatic epilepsies have atypical features that imitate the clinical characteristics of IGEs. Read More

Authors:

This review discusses a variety of causes of stupor and coma and associated electroencephalographic (EEG) findings. These include metabolic disturbances such as hepatic or renal dysfunction, which are often characterized by slowing of background rhythms and triphasic waves. Hypoxia and drug intoxications can produce a number of abnormal EEG patterns such as burst suppression, alpha coma, and spindle coma. Read More

Authors:

Due to technological advances, it is now feasible to record continuous digital EEG (CEEG), with or without video, in critically ill patients and review recordings remotely. Nonconvulsive seizures (NCSzs) are more common than previously recognized and are associated with worse outcome. The majority of seizures in ICU patients are nonconvulsive and will be missed without CEEG. Read More

Authors:

Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Despite advances in neuroimaging techniques over the past three decades that have helped in identifying structural lesions of the central nervous system, electroencephalography (EEG) continues to provide valuable insight into brain function by demonstrating focal or diffuse background abnormalities and epileptiform abnormalities. It is an extremely valuable test in patients suspected of epilepsy and in patients with altered mental status and coma. Patterns in the EEG make it possible to clarify the seizure type; it is indispensable for the diagnosis of nonconvulsive status epilepticus and for separating epileptic from other paroxysmal (nonepileptic) episodes. Read More

Authors:

Nonconvulsive status epilepticus (SE) is not uncommon and comprises at least one-third of all cases of SE. However, nonconvulsive SE consists of very different syndromes, a common feature being the difficulty in making the diagnosis. In this review, nonconvulsive SE is divided into typical absence SE, complex partial SE, nonconvulsive SE in patients with learning difficulties (including electrical SE during sleep, atypical absence SE and tonic SE), and nonconvulsive SE in coma. Read More

Authors:

Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pennsylvania, USA.

Severe brain disorders can be expressed as markedly abnormal encephalopathic EEG patterns in neonates who are usually neurologically depressed, with abnormal levels of reactivity and tone. This symptomatic group is now a minority of medically ill neonates as a result of more vigorous fetal and neonatal resuscitative efforts. Most neonates alternatively express brain dysfunction as more pervasive alterations in EEG-sleep organization or maturation, usually in the absence or after resolution of abnormal clinical signs. Read More

Authors:

Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pennsylvania, USA.

Neurophysiologic assessments using EEG/polysomnographic studies permit the clinician to recognize expected patterns of brain maturation in the healthy neonate. By comparison, one can detect encephalopathic behaviors of newborns who are medically at risk. Severe physiologic expressions of encephalopathy are associated with neuropathologic lesions on postmortem examinations, brain lesions documented on neuroimaging studies, and major neurodevelopmental sequelae of survivors. Read More

Authors:

Neonatal encephalopathies can be characterized in functional terms using electroencephalography. Severity of an encephalopathic state can also be estimated by electrographic interpretation independent of the time of disease process onset. Moderately or markedly abnormal electroencephalographic patterns on serial studies are highly correlated with neurologic sequelae in survivors. Read More

Authors:

We report the first case of nonconvulsive status epilepticus as a complication of chemotherapy with the nitrogen mustard derivative ifosfamide. Our patient developed encephalopathy, upper extremity myoclonus, and a periodic, triphasic electroencephalogic pattern that resolved acutely with intravenous diazepam treatment. Since significant morbidity and mortality is associated with unrecognized status epilepticus, electroencephalogic monitoring and a trial of diazepam is indicated in encephalopathic patients with rhythmic electroencephalogic patterns while receiving treatment with ifosfamide. Read More

Authors:

Department of Neurology, West Virginia University School of Medicine, Morgantown 26506.

Previous studies have suggested that EEG may be helpful in the diagnosis of herpes encephalitis (HE). To further define the value of EEG in an acutely ill, febrile, encephalopathic patient suspected as having encephalitis, we reviewed initial preoperative EEGs with the results of cerebral biopsies in 24 consecutive patients suspected of having encephalitis. Statistical analysis demonstrated that EEG patterns have only limited association with biopsy results. Read More